New York has become the first state to allow taxpayer-fundedresearchers to pay women for giving their eggs for embryonic stem cellresearch, a move welcomed by many scientists but condemned by criticswho fear it will lead to the exploitation of vulnerable women.
The Empire State Stem Cell Board, which decides how to spend $600million in state funding for stem cell studies, will allow researchersto compensate women up to $10,000 for the time, discomfort andexpenses associated with donating eggs for experiments.
"We want to enhance the potential of stem cell research. If we aregoing to encourage stem cell research as a solution for a variety ofdiseases, we should remove barriers to the greatest extent possible,"said David Hohn, vice chairman of the board's two committees thatendorsed the move. "We decided to break some new territory."
The little-noted decision two weeks ago puts New York at odds withpolicies in every other state that provides funding for humanembryonic stem cell research and with prevailing guidelines fromscientific organizations, including the National Academy of Sciences.
The move was welcomed, however, by proponents of stem cellresearch, stem cell scientists and some bioethicists, who said itwould remove a major obstacle to pursuing some of the most excitinggoals of the research -- including producing replacement tissuestailored to individual patients.
"This is a really great, appropriate policy," said Susan Solomon,co-founder of the New York Stem Cell Foundation, a private, nonprofitresearch organization. "This could help us to pursue some criticalexperiments that we hope will lead to treatments for devastatingdiseases."
But the decision was questioned by others, including opponents andsome proponents of stem cell research.
"In a field that's already the object of a great deal ofcontroversy, the question is, are we at the point where we really needto go that route in order to do the science?" said Jonathan Moreno, aprofessor of bioethics at the University of Pennsylvania. "I'm notconvinced."
Supporters consider human embryonic stem cell research one of mostpromising fields in biomedical science. Because the cells are believedcapable of becoming virtually any tissue in the body, researchers hopethey will lead to cures for a host of major afflictions, includingdiabetes, Parkinson's disease and paralysis. But the field is highlycontroversial, largely because the cells are derived by destroyingdays-old embryos, a process some consider the equivalent of killing aperson.
One of the goals of the research is to produce cells tailored toindividual patients through a process known as somatic cell nucleartransfer. Also called therapeutic cloning, the procedure involvesreplacing the genetic material in a human egg with genes from thenucleus of a patient's cell, and stimulating the egg to develop intoan early embryo. That could, theoretically, produce stem cells thatwould not be rejected by the recipient's immune system.
Although no one has succeeded in producing human stem cells thatway, researchers are trying and have been frustrated by the difficultyof obtaining eggs. Attempts to solicit women to donate eggs for suchresearch have largely failed.
"The lack of compensation has meant it's been nearly impossible toget enough eggs," said Douglas A. Melton, co-director of the HarvardStem Cell Institute in Boston.
Donors must undergo weeks of hormone injections to stimulate theirovaries to produce eggs and then a painful procedure to extract theeggs. The procedure can in rare cases cause a dangerousoverstimulation of the ovaries, and there are concerns about thepossible long-term risks of hormonal stimulation.
But proponents of reimbursing women have argued that fertilityclinics routinely pay women thousands of dollars to donate eggs tohelp infertile women have children.
In making its decision on June 11, the New York board argued thatthere was no reason that stem cell researchers should be precludedfrom offering women equivalent sums, although they stressed thatresearchers should follow the same guidelines as fertility clinics:Anything over $5,000 must be justified, and anything over $10,000would be excessive.
"We could not distinguish ethically between the payment for invitro fertilization, which is very well precedented, and thecompensation for donation for research," Hohn said.
Ronald Green, a Dartmouth College bioethicist, agreed.
"It is discriminatory against women to ban them from receivingpayment," Green said. "We pay for participation in research that hasrisks associated with it for other procedures. So why not this? Theidea that women cannot make that decision on their own strikes me assexist."
But Moreno, at the University of Pennsylvania, questioned whetherenough effort had been made to persuade women to donate eggs withoutcompensation. "I wonder if all the expertise that could be brought tobe bear on this problem of getting unreimbursed donation have beenexplored," he said.
Moreno and others also questioned equating egg donation forresearch with donation to help infertile women.
"People recognize that eggs can make a baby. That's a veryconcrete good for society. But you can't be sure any biologicalmaterial you collect for research will be part of a medicalbreakthrough. That's the goal, but you can't be sure," Moreno said.
Moreover, critics worry that the move could lead to theexploitation of women, especially poor women, who tend not to be indemand for infertility donation.
"With the economy the way it is, you don't need to be a rocketscientist to know that when a woman is looking at receiving up to$10,000 to sign up for research project, that's an undue inducement,"said Thomas Berg, a Catholic priest who directs the WestchesterInstitute for Ethics & the Human Person and serves on the Empire StateStem Cell Board's ethics committee. He opposed the decision. "I thinkit manipulates women. I think it creates a trafficking in human bodyparts."
Others agreed, calling it an unnerving precedent.
"Whenever society starts to pay for relationships that aretraditionally done with altruism and generosity within families, itraises the issue of whether there is anything that is not for sale,"said Laurie Zoloth, a Northwestern University bioethicist.
But supporters disputed such arguments.
"Women are perfectly capable in our society in deciding to getplastic surgery, Botox, donate a kidney. I find it patronizing beyondbelief. We compensate people in clinical trails for time and burdenall the time," Solomon said.
Although some argued that therapeutic cloning is no longernecessary because of the development of induced pluripotent stem cells(iPS), which are adult cells converted into the equivalent ofembryonic ones, others said that remains far from clear.
"IPS technology still to date has not produced cells that have allthe properties of embryonic stem cells," said Melton at Harvard. "Ibelieve those cells will be as good as embryonic stem cells, but we'renot there yet."